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1 <br />For all municipal business license questions, contact: City of South Bend • Department of Community Investment <br />227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021 <br /> <br /> <br /> <br />LICENSE APPLICATION FOR – VEHICLE REMOVAL SERVICE <br />MUNICIPAL CODE SECTION – 4-20.5 <br /> <br />I. APPLICATION TYPE Check One: New Renewal <br /> <br />II. BUSINESS DATA <br />A. Business Name: <br />B. Business Address: <br />City: State: Zip: <br />C. Mailing Address (If different from above): <br />City: State: Zip: <br />D. Business Telephone Number: <br />E. Business Fax Number: <br />F. E-Mail Address: <br />G. Insurance Carrier, Agent, and Amount of Liability Insurance: <br /> <br /> <br /> <br /> <br />III. PERSONAL DATA <br />A. Applicant's Legal Name: <br />B. Residential Address: <br />City: State: Zip: <br />C. Residential Telephone Number: <br />D. Cellphone Number: <br />E. Position with Business: <br /> <br /> <br /> <br />For Office Use Only <br /> <br />Application Filed Fire Dept. Approval <br />Application Fee Paid Police Dept. Approval <br />Sent to Dept. License Fee Paid <br />Code Enforcement Approval License Number <br /> <br />Not Approved <br />Reason